Minimally Invasive Surgery for Ablation of Osteoid Osteoma of the Spine

Hadjipavlou, Alexander; Lander, P; Marchesi, Dante; Katonis, Pavlos; Gaitanis, I.

doi:10.1097/01.brs.0000092386.96824.db

Cited by 65 publications

(46 citation statements)

References 33 publications

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“…In the literature, the heat dosage applied to the apex of the cauterization needle for the treatment of localized OO throughout is 4 min at 90°C [11,15] or 6 min at 90°C [9,17], with a success rate of approximately 90%.…”

Section: Discussionmentioning

confidence: 99%

Osteoid osteoma of the cervical spine: surgical treatment or percutaneous radiofrequency coagulation?

et al. 2007

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Osteoid osteoma (OO) of the cervical spine is frequently located close to the vertebral artery, spinal cord, or nerve roots and complete surgical excision is sometimes difficult by a limited approach and more extended surgery can require spinal fusion. Percutaneous radiofrequency coagulation (PRC) has demonstrated efficacy in the treatment of OO of the pelvis and limbs however, its role in the cervical spine is still nuclear. The Authors present a series of nine cases of OO of the cervical spine, six treated with surgical excision and three with PRC. No neurological or vascular complications occurred in both series. One case of the surgical series had only partial relief of persistent pain for 1 year due to incomplete excision, but is doing well 4 years after surgery. All the other surgical cases had complete relief of symptoms immediately after surgery and are symptom-free 3-10 years later. Two cases of PRC had complete relief of symptoms 24-48 h after surgery and are symptom-free 2 and 3 years later. One case of recurrent OO after surgery and treated with PRC with a reduced dose improved only, and still requires anti-inflammatory drugs 2 years after the procedure. Our still limited experience suggests that PRC can be safely performed in local anaesthesia with the patient awake, enabling to check for signs and symptoms of possible neurological injury. PRC can substitute extensive posterior approaches and reconstructions for OO of the posterior arch and joint pillar.

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Section: Discussionmentioning

confidence: 99%

Osteoid osteoma of the cervical spine: surgical treatment or percutaneous radiofrequency coagulation?

et al. 2007

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“…Accordingly, several authors are sceptical regarding RFA for spinal osteoid osteomas because of the potential neurologic risks [9,12,14,19,21] and therefore open resection is still the treatment of choice for lesions of the occipitocervical junction [3]. Nevertheless, radiofrequency ablation of a spinal osteoid osteoma has been primarily reported in 1998 [18] and in recent years several authors reported their experience [6,7,12,14,21,23]. Animal models of RFA have shown that it may be performed safely in the vertebral body but the temperature of the surrounding soft tissue depends on the thickness of the cortical bone lamella [1,7].…”

Section: Discussionmentioning

confidence: 99%

“…They mainly affect long bones of children and of young adults and occur in the spine with a frequency of about 10% [11]. Traditional therapy of spinal lesions consists of open intralesional resection but recent papers report the use of CT-guided radiofrequency ablation (RFA) [6,7,12,14,18,21,23]. Nevertheless, RFA in the spine is limited due to the possible thermal damage of neural structures while it is the treatment of choice for osteoid osteomas of the extremities.…”

Section: Introductionmentioning

confidence: 99%

The indication for gamma probe-guided surgery of spinal osteoid osteomas

et al. 2007

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The standard treatment for osteoid osteomas is CT-guided radiofrequency ablation (RFA). This minimally invasive procedure is effective in terms of pain reduction as well as the recurrence rate. Nevertheless, the use for spinal lesions is limited due to a possible thermal damage of neural structures. Although the literature is contradictory, RFA should only be used when a cortical shell between the lesion and the spinal canal is existent. We present seven cases (five males, two females, mean age 23 years) with spinal osteoid osteoma in which RFA was not applicable and open resection with the use of probe-guided surgery (PGS) was performed. The principle of PGS is that after preoperative bone scintigraphy, a handheld radiation probe is used intraoperatively for tumour localisation. Here, exposure and bone resection can be minimised and completeness of tumour excision may be estimated. At the initial measurement we found a hot-spot (maximum countrate) in all patients and after tumour resection, the signal decreased by a mean of 68% in the operative field. After a mean follow-up of 17 months one patient had residual pain but no patient had signs of tumour recurrence. The authors recommend to use PGS for those spinal osteoid osteomas where RFA is not applicable and intraoperative localisation-and here complete resection-of the tumour is difficult.

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“…Osti and Sebben reported on the first case of lumbar osteoid osteoma of the spine treated successfully by radiofrequency coagulation [11]. Other reports were less enthusiastic about the use of this technique in vertebral osteoid osteomas adjacent to neural elements, because of the potential risk of neurologic complications [3,8,12,14]. In an ex-vivo study measuring temperature changes in the adjacent spinal canal while applying radiofrequency to vertebral bodies in pigs, Dupuy et al [4] stated that there was no cytotoxic temperature elevations recorded in the spinal canal.…”

Section: Discussionmentioning

confidence: 99%

Percutaneous radiofrequency coagulation of osteoid osteoma of the “Neural Spinal Ring”

et al. 2005

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Minimally Invasive Surgery for Ablation of Osteoid Osteoma of the Spine

Abstract: Minimally invasive surgery can successfully be applied in the treatment of osteoid osteoma of the lumbar spine. When the nidus is not adjacent to the neural elements radiofrequency thermal ablation can be an effective and safe treatment of osteoid osteoma in the spine.

Cited by 65 publications

References 33 publications

Osteoid osteoma of the cervical spine: surgical treatment or percutaneous radiofrequency coagulation?

Osteoid osteoma of the cervical spine: surgical treatment or percutaneous radiofrequency coagulation?

The indication for gamma probe-guided surgery of spinal osteoid osteomas

Percutaneous radiofrequency coagulation of osteoid osteoma of the “Neural Spinal Ring”

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